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Substance Abuse Screening Instrument

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Case Of Michael

Lewis (2014) presented the case of Michael indicating that he is a 32-year-old male who has become physically and verbally abusive at home. He has recently begun to abuse drugs, cocaine, to alleviate the stress of his job and raising a family. Lewis (2014) also concluded that Michael was introduced to cocaine by his bar buddies two years ago and has been using it ever since to suffocate the strain of his life.

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Using the Case of Michael presented in the Lewis text (on pages 10-12), evaluate a substance abuse screening assessment tool listed in the CSAT TIP 42, Appendix H: "Screening Instruments." How would that tool provide useful information to help assess the appropriate level of care according to the American Society of Addiction Medicine (ASAM) criteria? (See CSAT TIP 47, Chapter 3: "Intensive Outpatient Treatment and the Continuum of Care.") What would need to be considered in using the selected assessment if Michael was not born in the United States and only had a limited command of English?

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Solution Summary

This solution describes a screening instrument for substance abuse within the American Society of Addiction Medicine (ASAM) guidelines.

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Comparing Assessment Tools for Addiction

(1) Evaluate a substance abuse screening assessment tool listed in the CSAT 42
Treatment Improvement Protocols or TIPS are best-practice guidelines for the treatment of substance use disorders. Regulated by the Center for Substance Abuse Treatment (CSAT), TIP is part of the Substance Abuse and Mental Health Services Administration (SAMHSA) efforts within the U.S. Department of Health and Human Services (DHHS) to reduce the number of addictions to drug and/or alcohol. To formulate guidelines for TIP programs, CSAT draws on the experience and knowledge of clinical, research, and administrative experts in that particular topic area. The American Society of Addiction Medicine (ASAM) criteria is based on six dimensions that are designed to create a holistic psychological assessment of an individual to be used for treatment purposes at various levels of care as follows.
• Dimension 1- acute intoxication and withdrawal potential-exploring an individual past and current use of substance and withdrawal.
• Dimension 2-Biomedical conditions and complications-Exploring an individual's history and current physical condition.
• Dimension 3-Emotion, Behavioral, or cognitive conditions and complications-Exploring thoughts, emotions and mental health issues.
• Dimension 4- Readiness to change-Exploring an individual readiness and interest in changing.
• Dimension 5-Relapse, continued use, or continued problem potential-Exploring an individual's unique relationship with relapse, continued use, or problem potential.
• Dimension 6-Recovery living environment-Exploring an individual's recovery or living situation, and surrounding people. Places and things (www.ncbi.nhm.nih.gov}.
ASAM models of intervention reflect a continuum of care that involves: Intensive outpatient services. Relative to the case study of Michael, brief interventions for substance abuse can be recommended. Research highlights the efficacy of brief intervention models of treating substance abuse by counselors, social workers, physicians, psychologists, and drug counseling. The practitioners engage in time-limited efforts to help clients stop using drugs; and are focused on a goal that is based on and applied to various levels of substance abuse (www.ncbi.nhm.nih.gov).
Numerous population-based studies and psychosocial treatments have been matched to stages of change or readiness for change models. 145Stages of Change (Norcross, Krebs, & Prochaska, 2011). Research has been presented that show interventions have been used to assess and provide specific feedback according to stage of change models, and other constructs, such as self- efficacy. Results of these studies clearly show the effectiveness of matching to the patient's stage of change to enhanced treatment effects (e.g., Dijkstra, Conijn, & de Vries, 2006; Prochaska, ...

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